Provider Demographics
NPI:1942699830
Name:PARTON, KATELYN (FNP-BC)
Entity Type:Individual
Prefix:
First Name:KATELYN
Middle Name:
Last Name:PARTON
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:KATELYN
Other - Middle Name:
Other - Last Name:REYNOLDS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:12900 TOWNE CENTER DR
Mailing Address - Street 2:#150
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-8546
Mailing Address - Country:US
Mailing Address - Phone:866-646-3553
Mailing Address - Fax:
Practice Address - Street 1:12898 TOWNE CENTER DR
Practice Address - Street 2:
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-8546
Practice Address - Country:US
Practice Address - Phone:866-646-3553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-15
Last Update Date:2015-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95001583363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily